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Impacts of Environmental Distractions and Interruptions on Unsupervised Digital Cognitive Assessments in Older Adults: Cognitive Ecological Momentary Assessment Study
Matthew S. Welhaf, Hannah Wilks, Andrew J. Aschenbrenner, Samhita Govindan Katteri, John C. Morris, Jason J. Hassenstab. JMIR mhealth and uhealth, 2025-08-06
Topic: Risk, prevention and care in population studies
Across all participants, momentary effects of environmental distractions were minimal. Specifically, when tests were completed in the presence of others, participants exhibited slightly increased variability in processing speed (P=.04). However, these momentary effects of environmental distractions were dependent upon cognitive status (P=.009). Cognitively normal older adults had better visuospatial working memory performance when they completed tests at home compared to when they completed tests away from home (P=.001). However, older adults with very mild dementia showed no effect of testing location on the same task (P=.36). Conversely, cognitively normal older adults did not differ in their processing speed at either testing location (P=.88). Older adults with very mild dementia were slightly faster when not at home (P=.04). Social context only impacted variability in processing speed for participants with very mild dementia (P=.04). When considering tests completed in the most distracting environments (away from home and in the presence of others), those with very mild dementia showed larger differences only on the visuospatial working memory measure. Additional analyses demonstrated that after removing sessions in which participants self-reported experiencing an interruption (1194/9633, 12.4% of all assessments), these small effects of environmental distractions on cognition remained, but were more apparent in those with very mild dementia. Social context and location of unsupervised remote cognitive testing have small impacts on performance, but these impacts were not consistent across cognitive domains and were mostly limited to participants demonstrating the earliest symptoms of dementia. Remote cognitive testing provides valid and reliable data in older adults, but care should be taken to allow participants to report distractions that may occur during testing.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Welhaf, M. S., Wilks, H., Aschenbrenner, A. J., Katteri, S. G., Morris, J. C., & Hassenstab, J. J. (2025). Impacts of Environmental Distractions and Interruptions on Unsupervised Digital Cognitive Assessments in Older Adults: Cognitive Ecological Momentary Assessment Study. JMIR mhealth and uhealth. https://doi.org/10.2196/71578
Vancouver
Welhaf MS, Wilks H, Aschenbrenner AJ, Katteri SG, Morris JC, Hassenstab JJ. Impacts of Environmental Distractions and Interruptions on Unsupervised Digital Cognitive Assessments in Older Adults: Cognitive Ecological Momentary Assessment Study. JMIR mhealth and uhealth. 2025. doi:10.2196/71578. PMID: 40921103.
BibTeX
@article{welhaf2025-40921103,
author = {Welhaf, Matthew S. and Wilks, Hannah and Aschenbrenner, Andrew J. and Katteri, Samhita Govindan and Morris, John C. and Hassenstab, Jason J.},
title = {{Impacts of Environmental Distractions and Interruptions on Unsupervised Digital Cognitive Assessments in Older Adults: Cognitive Ecological Momentary Assessment Study}},
journal = {JMIR mhealth and uhealth},
year = {2025},
doi = {10.2196/71578},
pmid = {40921103},
url = {https://doi.org/10.2196/71578}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
Key findings
- Across all participants, momentary effects of environmental distractions were minimal.
- Specifically, when tests were completed in the presence of others, participants exhibited slightly increased variability in processing speed (P=.04).
- However, these momentary effects of environmental distractions were dependent upon cognitive status (P=.009).
- Cognitively normal older adults had better visuospatial working memory performance when they completed tests at home compared to when they completed tests away from home (P=.001).
- However, older adults with very mild dementia showed no effect of testing location on the same task (P=.36).
Why it matters
This study found that environmental distractions had minimal effects on unsupervised digital cognitive assessments in older adults, with some effects depending on cognitive status. It is about the reliability of remote cognitive testing, not about treating, curing, or preventing Alzheimer's disease.
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Study details
- Participants380
- Effect size12.4%
- Evidence strengthLow
How this study scored 44/100
Published in a peer-reviewed journal. Scored zero for study design and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (JMIR mhealth and uhealth) |
| Journal's citation record | 1 / 4 | JMIR mhealth and uhealth: journal h-index 148 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 2 / 4 | 380 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 1 / 7 | Cited 3 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 1.0 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 2 / 6 | Cited 1.9× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 1 / 4 | Cited 3 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Jason J. Hassenstab: h-index 58 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | Washington University in St. Louis: institution h-index 1,962 (OpenAlex) |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 40921103) |
| Free to read | 2 / 2 | Free to read |
| Total | 44 / 100 | — |
What each of these 20 components measures, and what this score is not →
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